Individual provider Active NPI

Nicole Suzanne Litizzette-Witzel, DDS, MS

  • Periodontics
  • Austin, TX
National Provider Identifier
1487723730
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
24329 Issued in TX
Practice address
4201 Bee Caves Rd
Suite C211
Austin, TX 78746
Phone
(512) 306-8822
Fax
(512) 306-8848
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 8349 TN
Periodontics 1223P0300X 24329 TX Primary

Addresses

Primary practice location

4201 Bee Caves Rd
Suite C211
Austin, TX 78746

Mailing address

4201 Bee Caves Rd
Suite C211
Austin, TX 78746
Phone (512) 306-8822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130824000013 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1557504446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1487723730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 BEE CAVES RD",
            "address_2": "SUITE C211",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78746",
            "telephone_number": "512-306-8822",
            "fax_number": "512-306-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 BEE CAVES RD",
            "address_2": "SUITE C211",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78746",
            "telephone_number": "512-306-8822",
            "fax_number": "512-306-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITIZZETTE-WITZEL",
        "first_name": "NICOLE",
        "middle_name": "SUZANNE",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "8349",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "24329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.